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89
are distributed through all schools, welfare centres, and similar institutions. Much of the
time and energy of the staff is especially diverted to combat the spread, and the facilities for
nursing the cases at home are increased. In 1927 the Fever Hospitals adopted the practice of
admitting cases of Measles. Previously Scarlet Fever had the preference, almost to the
complete exclusion of Measles. During epidemic times, when there is a heavy demand for
beds, cases are only admitted on the recommendation of the Medical Officer of Health.
Measles is considered to be a more serious disease now than Scarlet Fever. It has a
higher Mortality Rate, and its complications are more numerous and often very serious
and crippling.
The Mortality Rate swings irregularly, but with a tendency to follow the curve of
incidence and not coincide with it.
In the 1928 Annual Report an investigation was made into the result of treatment at
home and in institutions, and the mortality of cases treated at home was shown to be
markedly less than that for cases removed either to Highgate or one of the Fever Hospitals.
There are many factors to consider in this brief statement, but it is evident that, unless home
conditions are bad, treatremit is batter there. Therefore, during epidemics cases are selected
for institutional treatment rather on account of home conditions than the gravity of the
attack of illness.
An analysis of the age distribution demonstrates that Measles is most common between
one and five years. It is not frequent in infancy and comparatively uncommon in adult life.
In epidemic years the mortality rate is very high in infancy.
The epidemic in 1930 was milder than usual. It lasted for a longer period, and was
more marked in the second than the first quarter of the year, which is unusual. Of the 3,476
cases which were notified, 360 were removed to hospitals, and there were 31 deaths registered
in the Borough as having been due to Measles. The services of a nurse were provided in all
cases where this was desired. This service is provided for under a block grant to the several
Nursing Associations, the details of which are given elsewhere in this Report. The routine is
for the Health Visitors to visit each notified case. Where the circumstances suggest the
desirability of a visiting nurse, a card is delivered to the medical attendant. If he agrees and
signs the card, the necessary visiting commences immediately. This is a very useful service,
but it is surprising how frequently doctors omit to take advantage of it.
German Measles is not common, and generally is a mild disease, and has therefore not
been analysed. There were 116 cases during the year, 5 were admitted to Hospitals, and
there were no deaths.